Medicare Advantage

Why Garner Has One Medicare Advantage Change Until March 31

Wake County has 63 Medicare Advantage plans for 2027. Compared with 2026, 19 plans are not coming back, 5 are new, and 35 continuing plans changed in some way you should check before December 7, 15 of them under a new name. This guide covers what those numbers mean for Garner, not which plan to pick.

GARNER, N.C. — If you signed up for a Medicare Advantage plan during the fall and are already second-guessing your choice, you have a built-in do-over. From January 1 through March 31, the Medicare Advantage Open Enrollment Period gives current Advantage members one chance to make a change — no special reason required.

This window is easy to miss because it comes right after the busy fall enrollment season. But for Garner residents who realize their new plan doesn't cover a preferred doctor, hospital, or medication, these three months are the time to act.

Who this window is for

The Medicare Advantage Open Enrollment Period (often called MA OEP) is different from the fall Annual Enrollment Period. It is only open to people who are already in a Medicare Advantage plan on January 1.

If you are on Original Medicare (Parts A and B) with or without a stand-alone Part D drug plan, this window is not for you. You would generally need to wait for the fall Annual Enrollment Period (October 15 – December 7) or qualify for a Special Enrollment Period.

What changes you can make

During January 1 – March 31, if you are enrolled in a Medicare Advantage plan you can:

• Switch to a different Medicare Advantage plan (with or without drug coverage).
• Drop your Medicare Advantage plan and go back to Original Medicare.
• If you return to Original Medicare, join a stand-alone Medicare Part D prescription drug plan.

You cannot use this window to join a Medicare Advantage plan for the first time from Original Medicare, and you cannot use it to switch from one stand-alone Part D plan to another.

You only get one change during this period. Your new coverage starts the first day of the month after your new plan gets your enrollment request.

Why Garner residents look at this window

Garner is in Wake County, where a wide range of Medicare Advantage and Part D plans are offered each year. Networks, drug lists (formularies), and extra benefits can change from one plan year to the next — even if you kept the same plan, your plan may not look the same in January.

Common reasons people use the January–March window include:

• Learning that a doctor or specialist is no longer in-network.
• Finding out a prescription is no longer covered or moved to a higher cost tier.
• Realizing a preferred hospital system is not part of the plan.
• Wanting to return to Original Medicare after trying Advantage for the first time.

How to decide before you switch

Before you make a change, gather your current plan's Evidence of Coverage and Annual Notice of Change. Compare them side by side with any plan you are considering. Focus on the pieces that affect you personally: your regular doctors, the pharmacies you use, your prescriptions, and any ongoing treatments.

A few program facts that may help frame your comparison:

• The Part D out-of-pocket cap is $2,100 for the year. Once your covered drug spending reaches that amount, you pay $0 for covered Part D drugs the rest of the year.
• The Part D deductible cannot be higher than $615.
• The old coverage gap (“donut hole”) is gone — Part D now has three phases instead of four.
• The Medicare Prescription Payment Plan lets you spread your drug costs into monthly payments instead of paying at the pharmacy counter.
• Higher-income beneficiaries may pay an IRMAA surcharge on Part B and Part D; for a single filer in 2026, that starts above $109,000 in income.

Where to get unbiased help

You do not have to figure this out alone, and you do not have to talk to an agent to get answers.

• Medicare.gov has a Plan Finder that lets you enter your medications and preferred pharmacies to compare coverage.
• 1-800-MEDICARE (1-800-633-4227) is available 24/7.
• North Carolina's SHIIP (Seniors' Health Insurance Information Program) offers free, one-on-one counseling from trained volunteers — no sales involved. Wake County residents, including those in Garner, can be connected to a local counselor.